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Start Over Author "Hira Shrestha" Journal journal of perinatology : official journal of the california perinatal association
2 results on '"Hira Shrestha"'

1. Quality improvement initiative to improve inpatient outcomes for Neonatal Abstinence Syndrome

Author

Fnu Nikita, Bonny L. Whalen, Crystal D. Alvarez, Robin Humphreys, Matthew Grossman, Elisha M. Wachman, Barbara L. Philipp, Camilla Farrell, Kelley Saia, Susan Minear, Jennifer Driscoll, Ahmad Khattab, Angela Nolin, Hira Shrestha, J. F. Burke, Karan Barry, Donna Stickney, Ginny Combs, Elizabeth Hutton, and Davida M. Schiff

Subjects
Adult, Male, medicine.medical_specialty, Quality management, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, 030225 pediatrics, Health care, medicine, Opiate Substitution Treatment, Humans, 030212 general & internal medicine, Hospital Costs, Adverse effect, Quality Indicators, Health Care, Inpatients, business.industry, Infant, Newborn, Obstetrics and Gynecology, Length of Stay, medicine.disease, Quality Improvement, United States, Opioid, Prenatal Exposure Delayed Effects, Pediatrics, Perinatology and Child Health, Emergency medicine, Female, business, Neonatal Abstinence Syndrome, Methadone, medicine.drug
Abstract

To improve Neonatal Abstinence Syndrome (NAS) inpatient outcomes through a comprehensive quality improvement (QI) program. Inclusion criteria were opioid-exposed infants ≥36 weeks. QI methodology including stakeholder interviews and plan-do-study-act (PDSA) cycles were utilized. We compared pre- and post-intervention NAS outcomes after a QI initiative that included: A non-pharmacologic care bundle, function-based assessments consisting of symptom prioritization and then the “Eat, Sleep, Console” (ESC) Tool; and a switch to methadone for pharmacologic treatment. Pharmacologic treatment decreased from 87.1 to 40.0%; adjunctive agent use from 33.6 to 2.4%; hospitalization length from a mean 17.4 to 11.3 days, and opioid treatment days from 16.2 to 12.7 (p

Published
2018

2. Implementation of a pilot program of Reach Out and Read® in the neonatal intensive care unit: a quality improvement initiative

Author

Alison Corning-Clarke, Anh Tran, Bernadette M. Levesque, Marsha Adams, Carole Ferguson, Hira Shrestha, Marilyn Valles, Emily M. Levesque, J. F. Burke, and Ramona Silva

Subjects
Program evaluation, Male, medicine.medical_specialty, Quality management, Neonatal intensive care unit, media_common.quotation_subject, education, MEDLINE, Pilot Projects, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Reading (process), Intensive Care Units, Neonatal, medicine, Pilot program, Humans, Parent-Child Relations, Program Development, Health Education, media_common, Academic Medical Centers, business.industry, Infant, Newborn, Obstetrics and Gynecology, Quality Improvement, Reading, Neurodevelopmental Disorders, Family medicine, Pediatrics, Perinatology and Child Health, Program development, Female, business, 030217 neurology & neurosurgery, Infant, Premature, Cohort study, Boston, Program Evaluation
Abstract

Language exposure is important for neurodevelopment, but is sparse in the neonatal intensive care unit (NICU). We introduced Reach Out and Read (ROR) in the NICU as a quality improvement initiative to increase language exposure. Measures included availability of books, accessibility of parents, and enrollment of infants, percent infants read to by their parents, and data from parental surveys. 98 infants were included (40 before, 58 after). We obtained books in the mother’s language for 95% of infants, 82% eligible infants were enrolled, and 70% read to their infants (mean of 0.45 ± 0.35 times/day). Surveyed parents enjoyed reading, noted positive effect(s), and intended to read post-discharge. We launched a well-received pilot ROR program in the NICU and reached our goal of ≥50% infants being read to by their parents. Further study is needed to assess the impact of reading in the NICU on parents and infants.

Published
2017

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